Provider Demographics
NPI:1487859492
Name:ALLERGY & ASTHMA CENTER OF CENTRAL MARYLAND, PA
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CENTER OF CENTRAL MARYLAND, PA
Other - Org Name:ALLERGY & ASTHMA CENTER OF CENTRAL MARYLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-730-6000
Mailing Address - Street 1:9891 BROKEN LAND PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1156
Mailing Address - Country:US
Mailing Address - Phone:410-730-6000
Mailing Address - Fax:410-997-5188
Practice Address - Street 1:9891 BROKEN LAND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1156
Practice Address - Country:US
Practice Address - Phone:410-730-6000
Practice Address - Fax:410-997-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD432LMedicare ID - Type Unspecified